This report uses data from the Survey of Income Program Participation (SIPP) to investigate dynamic aspects of the lack of health insurance, eligibility for Medicaid, and Medicaid participation among children in 1993 and 1994. After describing our data source we present findings on the duration of spells of uninsurance based on an analysis of new

Table 2 reports estimates of the health insurance coverage of children under 19 in each of the first three waves of the 1992 SIPP panel. These results are based on the full panel sample--that is, sample members who were present for the duration of the panel or until such time as they left the SIPP universe. Results are presented for the one month

The SIPP ascertains health insurance coverage by means of a series of questions that ask about specific types of coverage or about coverage in general. These questions are placed relatively early in the SIPP interview, when respondents are likely to be more attentive. By contrast, the health insurance questions in the March supplement to the Curre

Table 1 presents comparative estimates of the population of children represented by the SIPP panel sample and the population of children represented by the individual calendar month samples. The latter estimates were obtained by summing the calendar month weights by single year of age for selected months. These population totals represent, approxi

It is important to recognize the implications of the SIPP’s longitudinal design for the representativeness of the information that it collects. The SIPP sample is selected from the resident population of the United States, excluding persons living in military barracks or institutions. The sample is designed to be representative of this populatio

Several features of the SIPP make these data especially appealing for the analysis of children’s health insurance coverage. The SIPP provides a detailed measure of health insurance coverage for every month of the two to three year duration of a panel. Because of the SIPP rotation group design, the estimates for a given calendar month are based o

The data on which this report is based are from the 1992 panel of the SIPP. The SIPP is a longitudinal survey whose respondents are interviewed every four months about their activity during the preceding four months. The questions include a lengthy series of “core” items, included in every interview, and periodic “topical modules” that col

Using data from the Survey of Income and Program Participation (SIPP), this report examines issues related to the measurement of health insurance coverage and Medicaid participation and the simulation of Medicaid eligibility and draws some observations about the sources of health insurance coverage among children, the frequency with which children

Examining the dynamics of health insurance coverage among children tells us much about the magnitude of the task of insuring the uninsured. While policymakers and researchers tend to focus on the number of children who are without insurance at any one time, children who experience one or more months without insurance over the course of a two-year

1. Our simulation did not encompass all categories of eligibility; nor could it take account of the full range of income disregards that states might apply to individual cases. For this reason, we do not include in our participation rate those children who were reported as Medicaid participants but were simulated to be ineligible.

Our simulation of Medicaid eligibility revealed that 2.9 million, or 33 percent, of the estimated 8.9 million uninsured children in September 1994 were eligible for Medicaid. This is comparable to what other researchers have reported with more limited Medicaid eligibility simulations (Lewis et al.

With no adjustment for the Medicaid undercount in the SIPP, the reported participation in Medicaid is 65 percent among children who we simulated to be eligible. 1 If we exclude from the denominator those eligible nonparticipants who reported some other source of coverage, the participation rate rises to 79 percent. With an undercount adjustment

1. For example, under provisions included in the Omnibus Budget Reconciliation Act, states were required to cover infants and children under age 6 in families with incomes below 133 percent of the federal poverty level and to cover older children born after September 30, 1983 in families below 100 percent of poverty. Many states exercised an optio

Differences in the characteristics of children with long versus short spells without insurance are also potentially important to the design of programs as well as targeted outreach. However, children who experience long spells without insurance do not appear to be strikingly different from children who experience relatively brief spells without in

In general, uninsured children who are Medicaid-eligible resemble Medicaid participants, which supports the contention that many of these children are either in transition to Medicaid or are enrolled but have not reported their coverage. However, these two groups of people differ notably from each other in four areas:

It is important to measure the relationship between age and health insurance coverage because age differences in coverage reflect experiences over the life cycle. Both the probability of being uninsured and the average time without insurance increase with age--a finding established by longitudinal analysis. To generate findings like this, we follo

Children's coverage tends to mirror that of their parents, but the exceptions to this rule pose interesting questions for policymakers and analysts. About one-fifth of uninsured children appear to have at least one insured parent--a situation that merits further research to establish if and why it is true. Between 7 and 8 percent of uninsured chil

Pages

Survey Disclaimer

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0379. The time required to complete this information collection is estimated to average 5 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer.